Single lumen gas sealed access port for use during endoscopic surgical procedures

ABSTRACT

A system for performing an endoscopic surgical procedure in a surgical cavity of a patient that includes a multi-lumen tube set including a dual lumen portion having a pressurized gas line and a return gas line for facilitating gas recirculation relative to the surgical cavity of the patient, and a single lumen portion having a gas supply and sensing line for delivering insufflation gas to the surgical cavity of the patient and for periodically sensing pressure within the surgical cavity of the patient, a first gas sealed single lumen access port communicating with the dual lumen portion of the tube set and a second valve sealed single lumen access port communicating with the single lumen portion of the tube set.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of priority to U.S. ProvisionalPatent Application Ser. No. 62/468,417 filed Mar. 8, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

BACKGROUND OF THE INVENTION 1. Field of the Invention

The subject invention is directed to endoscopic surgery, and moreparticularly, to a surgical gas circulation system with multi-lumen tubeset connected with a single lumen gas sealed access port and a singlelumen valve sealed access port for use during an endoscopic orlaparoscopic surgical procedure.

2. Description of Related Art

Laparoscopic or “minimally invasive” surgical techniques are becomingcommonplace in the performance of procedures such as cholecystectomies,appendectomies, hernia repair and nephrectomies. Benefits of suchprocedures include reduced trauma to the patient, reduced opportunityfor infection, and decreased recovery time. Such procedures within theabdominal (peritoneal) cavity are typically performed through a deviceknown as a trocar or cannula, which facilitates the introduction oflaparoscopic instruments into the abdominal cavity of a patient.

Additionally, such procedures commonly involve filling or “insufflating”the abdominal cavity with a pressurized fluid, such as carbon dioxide,to create an operating space, which is referred to as apneumoperitoneum. The insufflation can be carried out by a surgicalaccess device, such as a trocar, equipped to deliver insufflation fluid,or by a separate insufflation device, such as an insufflation (veress)needle. Introduction of surgical instruments into the pneumoperitoneumwithout a substantial loss of insufflation gas is desirable, in order tomaintain the pneumoperitoneum.

During typical laparoscopic procedures, a surgeon makes three to foursmall incisions, usually no larger than about twelve millimeters each,which are typically made with the surgical access devices themselves,often using a separate inserter or obturator placed therein. Followinginsertion, the obturator is removed, and the trocar allows access forinstruments to be inserted into the abdominal cavity. Typical trocarsprovide a pathway to insufflate the abdominal cavity, so that thesurgeon has an open interior space in which to work.

The trocar must also provide a way to maintain the pressure within thecavity by sealing between the trocar and the surgical instrument beingused, while still allowing at least a minimum amount of freedom ofmovement for the surgical instruments. Such instruments can include, forexample, scissors, grasping instruments, and occluding instruments,cauterizing units, cameras, light sources and other surgicalinstruments. Sealing elements or mechanisms are typically provided ontrocars to prevent the escape of insufflation gas from the abdominalcavity. These sealing mechanisms often comprise a duckbill-type valvemade of a relatively pliable material, to seal around an outer surfaceof surgical instruments passing through the trocar.

SurgiQuest, Inc., a wholly owned subsidiary of ConMed Corporation hasdeveloped unique gas sealed surgical access devices that permit readyaccess to an insufflated surgical cavity without the need forconventional mechanical valve seals, as described, for example, in U.S.Pat. No. 7,854,724. These devices are constructed from several nestedcomponents including an inner tubular body portion and a coaxial outertubular body portion. The inner tubular body portion defines a centrallumen for introducing conventional laparoscopic surgical instruments tothe abdominal cavity of a patient and the outer tubular body portiondefines an annular lumen surrounding the inner tubular body portion fordelivering insufflation gas to the abdominal cavity of the patient andfor facilitating periodic sensing of abdominal pressure.

While these earlier developed dual lumen gas sealed access devicesprovide significant benefits and improvements over conventional singlelumen valve sealed access devices, they do present certain disadvantagesin the performance of a laparoscopic surgical procedure. In particular,because these earlier developed dual lumen gas sealed access devices areconstructed with two coaxial tubular body portions, the effective outerdiameter of the tubular body of the access device is significantlygreater than the effective outer diameter of the tubular body of aconventional single lumen valve sealed access device.

For example, the outer diameter of the dual lumen gas sealed accessdevice may be at least 2.0 mm greater than the outer diameter of aconventional single lumen valve sealed access device. Consequently, thelength of the incision that is required to introduce the dual lumenaccess device into the abdominal cavity will be greater than the typicalincision that is made for introducing a conventional single lumen valvesealed access device. This larger incision can increase the degree ofpatient trauma, cause larger and more visible scars for the patient,more pain or pain medication, and more difficult wound closure for thesurgeon.

It would be beneficial therefore to provide a gas sealed surgical accessdevice that overcomes the disadvantages associated with earlierdeveloped dual lumen gas sealed access devices, such as those disclosedin U.S. Pat. No. 7,854,724, while maintaining the substantial benefitsthey provide over conventional single lumen valve sealed access devices.The subject invention provides such a novel access device and a filteredtube set for the device for use in endoscopic surgery, which isdescribed in detail herein below.

SUMMARY OF THE DISCLOSURE

The subject invention is directed to a new and useful system forperforming an endoscopic or laparoscopic surgical procedure in asurgical cavity of a patient. The system includes a multi-lumen tube setincluding a dual lumen portion and a single lumen portion. The duallumen portion of the tube set has a pressurized gas line and a returngas line, which together facilitate gas recirculation relative to thesurgical cavity of the patient. The single lumen portion of the tube sethas a gas supply and sensing line for delivering insufflation gas to thesurgical cavity of the patient and for periodically sensing pressurewithin the surgical cavity of the patient. Preferably, the tube set isoperatively associated with a multi-path filter cartridge assembly.

The system further includes a first access port having a proximalhousing portion and an elongated tubular body portion extending distallyfrom the proximal housing portion and defining a central cannula orbore. The proximal housing portion of the first access port has an inletpath for communicating with the pressurized gas line of the tube set andan outlet path for communicating with the return gas line of the tubeset. The proximal housing portion accommodates an annular jet assemblyfor receiving pressurized gas from the inlet path and for generating agaseous sealing zone within the central cannula of the body portion tomaintain a stable pressure within the surgical cavity of the patient.

The system also includes a second access port having a proximal housingportion and a tubular body portion extending from the proximal housingportion. The proximal housing portion of the second access portaccommodates a mechanical valve for sealing the tubular body portion andan inlet path for communicating with the gas supply and sensing line ofthe tube set.

Preferably, the first access port is adapted and configured to performsmoke evacuation from the surgical cavity of the patient in conjunctionwith the second access port. In one embodiment of the invention, thefirst access port is adapted and configured to permit air entrainment,emergency relief of cavity pressure and instrument access into thecentral cannula during a surgical procedure. In another embodiment ofthe invention, the first access port is adapted and configured to permitair entrainment and emergency relief of cavity pressure, but withoutpermitting instrument access into and/or through the central cannula. Inthis regard, the central bore of the cannula may be shaped, dimensioned,louvered or otherwise configured to prevent instrument accesstherethrough.

In another embodiment, the first access port includes a proximal housingportion that is adapted to be selectively coupled with the tubular bodyportion thereof, and wherein the tubular body portion is configured formanipulation by a robotic surgical system, such as, for example, DaVinci robotic system manufactured by Intuitive Surgical, Inc. Forexample, the proximal housing portion may be selectively coupled to thetubular body portion by a pair of diametrically opposed cantilevered orspring loaded locking tabs or the like. The locking tabs can be providedon the proximal housing portion or on the tubular body portion. Thetubular body portion would include a grasping flange for enabling arobotic manipulator to grasp and move the abdominal port during asurgical procedure.

Alternatively, in this embodiment, the first access port includes aproximal housing portion that is adapted to be selectively coupled withthe tubular body portion thereof, wherein the tubular body portion is ofa proprietary design, or wherein the tubular body portion is of anon-proprietary design.

In accordance with a preferred embodiment of the subject invention, theproximal housing portion includes a manifold defining the gas inlet pathand the gas outlet path for the access port. Preferably, the inlet andoutlet paths are concentrically arranged within the manifold, and thedual lumen portion of the tube set includes a coaxial connector forcoupling with the manifold. Alternatively, the inlet and outlet pathsare arranged in parallel within the manifold, and the dual lumen portionof the tube set includes a suitable connector for coupling with themanifold. In comparison, the single lumen portion of the tube set caninclude a luer type connector for coupling with a conventional luer typefitting associated with the inlet path of the second access port.

The system further includes a gas recirculation apparatus including apump having an outlet for delivering pressurized gas to the tube set andan inlet for receiving depressurized gas from the return line of thetube set through the filter cartridge assembly. The apparatus is alsoconfigured to deliver insufflation gas to the gas supply and sensingline of the tube set from a gas source, as disclosed, for example, incommonly assigned U.S. Pat. No. 9,375,539. In accordance with apreferred embodiment of the subject invention, the gas recirculationapparatus may include a programmable controller with software that isadapted and configured to detect the presence of the bifurcatedmulti-lumen tube set and is able to differentiate it from a differenttype tube set.

The subject invention is also directed to a new and useful surgicalaccess port for performing an endoscopic surgical procedure in asurgical cavity of a patient, which includes a proximal housing portionand an elongated tubular body portion extending distally from theproximal housing portion and defining a central cannula or bore. Theproximal housing portion has an inlet path for communicating with apressurized gas line of a tube set and an outlet path for communicatingwith a return gas line of the tube set. The proximal housing portionaccommodates an annular jet assembly for receiving pressurized gas fromthe inlet path and for generating a gaseous sealing zone within thecentral cannula of the body portion to maintain a stable pressure withinthe surgical cavity of the patient.

The subject invention is also directed to new and useful multi-lumentube set for performing an endoscopic surgical procedure in a surgicalcavity of a patient, which includes a multi-path filter cartridgeassembly, a dual lumen portion communicating with the filter cartridgeassembly and having a pressurized gas line and a return gas line forfacilitating gas recirculation relative to the surgical cavity of thepatient, and a single lumen portion communicating with the filtercartridge assembly and having a gas supply and sensing line fordelivering insufflation gas to the surgical cavity of the patient andfor periodically sensing pressure within the surgical cavity of thepatient. Preferably, the dual lumen portion of the tube set includes aunique coaxial connector, and the single lumen portion of the tube setcan include a conventional luer type connector.

The subject invention is also directed to a novel method of retrofittinga separable two-part valve sealed surgical access port to perform anendoscopic surgical procedure in a surgical cavity of a patient. Themethod includes the step of obtaining a separable two-part surgicalaccess port having a valve sealed proximal housing portion that isdetachably engaged to a single lumen tubular body portion.

The method further incudes the steps of detaching the valve sealedproximal housing portion from the single lumen tubular body portion andthen attaching a gas sealed proximal housing portion to the single lumentubular body portion, wherein the tubular body portion may be configuredfor manipulation by a robotic surgical system. The method furtherincludes the step of connecting the gas sealed proximal housing portionto a source of pressurized gas for generating a gaseous sealing zonewithin a central cannula of the single lumen tubular body portion tomaintain a stable pressure within the surgical cavity of the patient.

The subject invention is also directed to a method of retrofitting areusable portion of a separable two-part valve sealed surgical accessport to perform an endoscopic surgical procedure in a surgical cavity ofa patient. The method includes the step of obtaining a reusable portionof a surgical access port normally having a valve sealed proximalhousing portion that is detachably engaged to a reusable single lumentubular body portion.

The method further incudes the steps of attaching a gas sealed proximalhousing portion to the reusable single lumen tubular body portion,wherein the reusable tubular body portion may be configured formanipulation by a robotic surgical system. The method further includesthe step of connecting the gas sealed proximal housing portion to asource of pressurized gas for generating a gaseous sealing zone within acentral cannula of the reusable single lumen tubular body portion tomaintain a stable pressure within the surgical cavity of the patient.

These and other features of the gas circulation system and the singlelumen gas sealed access device of the subject invention will become morereadily apparent to those having ordinary skill in the art to which thesubject invention appertains from the detailed description of thepreferred embodiments taken in conjunction with the following briefdescription of the drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

So that those skilled in the art will readily understand how to make anduse the gas circulation system and gas sealed abdominal access devicesof the subject invention without undue experimentation, preferredembodiments thereof will be described in detail herein below withreference to the figures wherein:

FIG. 1 is a perspective view of the gas circulation system of thesubject invention in use during the performance of a laparoscopicsurgical procedure, wherein the gas circulation system includes amulti-lumen filtered tube set having a dual lumen portion connected to asingle lumen gas sealed access port configured for maintaining a stablepneumoperitoneum within the abdominal cavity of the patient and forfacilitating smoke evacuation from the abdominal cavity, and a singlelumen portion connected to a single lumen valve sealed access portconfigured for insufflation and abdominal pressure sensing;

FIG. 2 is a perspective view of the gas circulation system shown in FIG.1, including a filter cartridge assembly, and a multi-lumen filteredtube set having a dual lumen portion connected to a single lumen gassealed access port and a single lumen portion connected to a singlelumen valve sealed access port;

FIG. 3 is a perspective view of the multi-lumen filtered tube set of thesubject invention, wherein a conventional luer connector is associatedwith the single lumen portion of the tube set and a dual lumen connectorwith concentric flow passages is associated with the dual lumen portionof the tube set;

FIG. 3A is a perspective view on another multi-lumen tube set of thesubject invention, wherein the dual lumen portion is bifurcated and eachof the tubes has a separate connector;

FIG. 4 is an enlarged localized perspective view of the tube fitting onthe filter cartridge assembly shown in FIG. 3, with parts separated forease of illustration;

FIG. 5 is a perspective view of a single lumen gas sealed access portconstructed in accordance with a preferred embodiment of the subjectinvention;

FIG. 5A is a perspective view of the housing portion of a single lumengas sealed access port similar to the embodiment of FIG. 5, but with adifferent manifold arrangement of the inlet and outlet paths;

FIG. 6 is an exploded perspective view the single lumen gas sealedaccess port shown in FIG. 5, with parts separated for ease ofillustration;

FIG. 7 is a perspective view of the annular jet assembly shown in FIG.6, with parts separated for ease of illustration;

FIG. 8 is a cross-sectional view of the single lumen gas sealed accessport, taken along line 8-8 of FIG. 5, illustrating the interior of theproximal housing portion that accommodates an annular jet assembly shownin FIG. 7, which generates a gaseous sealing zone within the centralbore of the cannula to maintain stable pressure within the surgicalcavity of a patient;

FIG. 9 is an enlarged localized view of the distal end portion of thesingle lumen gas sealed access port of FIG. 5, which has an outerdiameter D₂;

FIG. 10 is an enlarged localized view of the distal end portion of aprior art dual lumen gas sealed access port, which has an outer diameterD₁;

FIG. 11 is a perspective view of a single lumen gas sealed trocarconstructed in accordance with a preferred embodiment of the subjectinvention which has a slotted or louvered end cap configured for airentrainment and emergency pressure relief, without permitting instrumentaccess to the central bore of the cannula;

FIG. 12 is a top plan view of the single lumen gas sealed trocar shownin FIG. 11;

FIG. 13 is a perspective view of another embodiment of a single lumengas sealed trocar as in FIG. 11, which has a non-linear tubular bodyportion;

FIG. 14 is a perspective view of another embodiment of a single lumengas sealed trocar constructed in accordance with the subject inventionwhich is configured for air entrainment and emergency pressure relief,without permitting instrument access through the central bore of thecannula, wherein the trocar includes a closed obturator tip to preventpassage of an instrument through the cannula into the surgical cavity;

FIG. 15 is an exploded perspective view of the gas sealed trocar of FIG.14, with parts separated for ease of illustration;

FIGS. 16 and 17 are perspective views of another embodiment of a singlelumen gas sealed trocar constructed in accordance with the subjectinvention, wherein the trocar includes a tubular body portion with acentral cannula or bore that is dimensioned to prevent instrumentpassage therethrough, while permitting access to an obturator;

FIG. 18 is a side elevational view of another embodiment of a singlelumen gas sealed trocar constructed in accordance with the subjectinvention, wherein the trocar includes a tubular body portion with anelliptical cross-section that is shaped to prevent instrument passagetherethrough, while permitting access to an obturator, and alsoincluding an adhesive pad for retention purposes;

FIG. 19 is a perspective view of the single lumen gas sealed trocarshown in FIG. 18, during introduction of the obturator;

FIG. 20 is a cross-sectional view of the body portion of the trocartaken along line 20-20 of FIG. 19;

FIGS. 21-24 illustrate yet another embodiment of a single lumen gassealed trocar constructed in accordance with the subject invention whichis configured for air entrainment and emergency pressure relief, withoutpermitting instrument access to the central bore of the cannula, whereinthe trocar includes a mechanically actuated slotted or louvered end capthat is mounted to move into a closed and locked position when anobturator is removed from the device;

FIG. 25 is a perspective view of a gas circulation system constructed inaccordance with the subject invention that is adapted and configured foruse during a robotically assisted surgical procedures, which includes amulti-lumen filtered tube set, a two-part single lumen gas sealed accessport with a detachable housing portion and a two-part single lumen valvesealed access port with a detachable housing portion;

FIG. 26 is a perspective view of the single lumen gas sealed access portshown in FIG. 25, which includes a reusable distal cannula portionconfigured for robotic manipulation and a detachable housing portionconfigured for gaseous sealing, gas recirculation and smoke evacuation;

FIG. 27 is an exploded perspective view of the single lumen gas sealedaccess port of FIG. 26, with the housing portion separated from thereusable cannula or tubular body portion for ease of illustration;

FIG. 27A is an exploded perspective view of an alternative version ofthe single lumen gas sealed access port of FIG. 26, wherein the manifoldincludes parallel connectors as opposed to a concentric connector;

FIG. 28 is a side elevational view of the separable housing portion ofthe single lumen gas sealed access port of FIG. 26;

FIG. 29 is an exploded perspective view of the separable housing portionof the single lumen gas sealed access port of FIG. 26, with thecomponent parts thereof separated for ease of illustration.

FIG. 30 is a cross-sectional view of the separable housing portion ofthe single lumen gas sealed access port taken along line 30-30 of FIG.28;

FIG. 31 is a perspective view of a gas circulation system constructed inaccordance with the subject invention that is adapted and configured foruse during an endoscopic or laparoscopic surgical procedure, whichincludes a multi-lumen filtered tube set, a single lumen gas sealedaccess port with a detachable housing portion and a single lumen valvesealed access port with a detachable housing portion;

FIG. 32 is a perspective view of the single lumen gas sealed access portshown in FIG. 31, which includes a distal cannula portion and adetachable housing portion configured for gaseous sealing, gasrecirculation and smoke evacuation;

FIG. 33 is an exploded perspective view of the single lumen gas sealedaccess port of FIG. 32, with the housing portion separated from thetubular body portion for ease of illustration;

FIG. 34 is an exploded perspective view of the separable housing portionof the single lumen gas sealed access port of FIG. 32, with thecomponent parts thereof separated for ease of illustration; and

FIGS. 35-38 illustrate the method steps involved in retrofitting aseparable two-part valve sealed access port to perform an endoscopicsurgical procedure in a surgical cavity of a patient, wherein:

FIG. 35 shows a separable two-part access port having a valve sealedproximal housing portion that is detachably engaged to a single lumentubular body portion;

FIG. 36 shows detaching the valve sealed proximal housing portion fromthe single lumen tubular body portion of the access port;

FIG. 37 shows attaching a gas sealed proximal housing portion to thesingle lumen tubular body portion of the access port; and

FIG. 38 shows the fully assembled single lumen gas sealed access port,as illustrated in FIG. 32.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to the drawings wherein like reference numerals identifysimilar structural elements and features of the subject invention, thereis illustrated in FIG. 1 a gas circulation system for performing anendoscopic surgical procedure in a surgical cavity of a patient, andmore particularly, for performing a laparoscopic surgical procedure inthe abdominal cavity of a patient that is constructed in accordance witha preferred embodiment of the subject disclosure and is designatedgenerally by reference numeral 10.

The gas circulation system 10 is specifically designed to cooperate witha programmable multi-modal gas delivery system 12. The gas deliverysystem 12 is of the type described in commonly assigned U.S. Pat. No.9,375,539, the disclosure of which is herein incorporated by referencein its entirety. The gas delivery system 12 includes a graphical userinterface 14 for setting operating parameters and a pump 16 forfacilitating the recirculation of pressurized gas relative to thesurgical cavity of the patient. The gas delivery system 12 is connectedto a source of surgical gas 18 for delivering insufflation gas to thesurgical cavity of the patient.

In brief, the gas circulation system 10 incudes a multi-lumen filteredtube set 20 including a dual lumen portion 22 and a single lumen portion24, a first gas sealed single lumen access port 26 operatively connectedto the dual lumen portion 22 of the tube set 20 and a second valvesealed single lumen access port 28 operatively connected to the singlelumen portion 24 of the tube set 20. Each of these components of the gascirculation system 10, and variations thereof, will be described ingreater detail herein below.

The Multi-Lumen Tube Set

Referring to FIGS. 2-4, the gas circulation system 10 of the subjectinvention includes a multi-lumen filtered tube set designated generallyby reference numeral 20 that includes a dual lumen portion 22 and asingle lumen portion 24. The dual lumen portion 22 has a pressurized gasline 30 and a return gas line 32 for facilitating gas recirculationrelative to the surgical cavity of the patient. The single lumen portion24 has a gas supply and sensing line 34 for delivering insufflation gasto the surgical cavity of the patient and for periodically sensingpressure within the surgical cavity of the patient.

The tube set 20 is operatively associated with a multi-path filtercartridge assembly 36. More particularly, the gas lines of the tube set20 extend from a fitting 38 on the end cap 40 of the filter cartridgeassembly 36. A filter cartridge assembly of this type is disclosed forexample in commonly assigned U.S. Pat. No. 9,067,030 the disclosure ofwhich is herein incorporated by reference in its entirety. The filtercartridge assembly 36 is preferably designed for a single use and isthereafter disposable. It is specifically designed to cooperate with themulti-modal gas delivery system 12, illustrated in FIG. 1 and describedin commonly assigned U.S. Pat. No. 9,375,539.

While not shown here, the filter cartridge assembly 36 includes a firstfiltered flow passage communicating with the pressurized gas line 30 ofthe dual lumen portion 22 of the tube set 20, a second filtered flowpassage communicating with the return gas line 32 of the dual lumenportion 22 of the tube set 20, and a third filtered flow passagecommunicating with the gas supply and sensing line 34 of the singlelumen portion 24 of the tube set 20.

As shown in FIGS. 2, 3 and 3A, the single lumen portion 24 of the tubeset 20 includes a standard luer type connector 44 for connecting to aluer connection 25 on the valve sealed access port 28. The dual lumenportion 22 of the tube set 20 includes a dual lumen manifold connector42 with coaxial flow passages for mating with a dual lumen manifoldconnector 60 on gas sealed access portion 26. In a preferred embodimentof the subject invention, the dual lumen portion 22 of the tube set 20is at least partially formed as a conjoined extrusion, as best seen inFIG. 4. Alternatively, as shown in FIG. 3A, the dual lumen portion 22 oftube set 20 can be distally bifurcated into two separated gas lines 30and 32, each with a single connector for mating with a correspondinglyconfigured access port manifold, as shown for example in FIG. 14.

Single Lumen Gas Sealed Access Port

With continuing reference to FIGS. 1 and 2 in conjunction with FIGS.5-9, the circulation system 10 includes a gas sealed single lumen accessport 26 that is adapted and configured to provide gas sealed access tothe surgical cavity of a patient during an endoscopic surgicalprocedure. In this regard, access port 26 functions similar to thedual-lumen trocar assembly that is disclosed, for example, in commonlyassigned U.S. Pat. No. 7,854,724, the disclosure of which is hereinincorporated by reference in its entirety. However, access port 26differs significantly from the trocar assembly disclosed in U.S. Pat.No. 7,854,724 in that it has only one central lumen.

The access port 26 of the subject invention does not have a secondannular lumen surrounding the central lumen, as shown for example in theprior art FIG. 10. Thus, access port 26 is not capable of deliveringinsufflation gas to the surgical cavity of a patient, nor is it capableof sensing cavity pressure. Rather, access port 26 is configured toprovide gas sealed instrument access while facilitating the maintenanceof stable cavity pressure and smoke evacuation from the surgical cavity.The access port 26 will be described in greater detail below with regardto FIGS. 5 through 9.

Referring now to FIGS. 5 through 9, there is illustrated in more detailthe single lumen gas sealed access port 26 of the subject invention,which includes a proximal housing portion 50 and an elongated tubularbody portion 52 extending distally from the proximal housing portion 50and defining a central cannula 54. The proximal housing portion 50 ofaccess port 26 has an inlet path 56 for communicating with thepressurized gas line 30 of the tube set 20 and an outlet path 58 forcommunicating with the return gas line 32 of the tube set 20.

More particularly, as best seen in FIGS. 5 and 8, to manage gas flow inthe access port 26, the proximal housing portion 50 includes a manifold60 defining the inlet path 56 and the outlet path 58 which areconcentrically arranged within the manifold 60. The dual lumen portion22 of the tube set 20 includes the coaxial connector 42 for couplingwith the manifold 60 of the proximal housing portion 50, as best seen inFIG. 2. A dual lumen coupled connection of this type is disclosed, forexample, in FIG. 21 of commonly assigned U.S. Patent ApplicationPublication 2017/0361084, the disclosure of which is incorporated hereinby reference in its entirety. Alternatively, the single lumen gas sealedaccess port 26 could have a manifold 60 with two independent parallelconnectors 56 and 58, as shown in FIG. 5A.

Referring to FIGS. 6 and 8, the proximal housing portion 50 of accessport 26 defines an interior chamber 62 to accommodate a two-part annularjet assembly 64, which is best seen in FIG. 7. An end cap 76 covers theinterior chamber 62 and defines an entry path for the central cannula54. The annular jet assembly 64 is adapted and configured to receivepressurized gas from the inlet path 56 and for generating a gaseous orpneumatic sealing zone within the central cannula 54 of the tubular bodyportion 52 to maintain a stable pressure within the surgical cavity ofthe patient.

Referring to FIG. 7, the annular jet assembly 64 includes an upper jetring 66 having a nozzle tube 68 and a lower jet ring 70 defining anozzle seat 72 for receiving the nozzle tube 68. The upper jet ring 66and lower jet ring 70 each has an 0-ring 75 and they are joined togetherby a plurality of interfitting lugs 74. The annular jet assembly 64 isdisclosed in great detail in commonly assigned U.S. Pat. No. 8,795,223and U.S. Patent Application Publication 2015/0025323, the disclosures ofwhich are herein incorporated by reference in their entireties.

There are several advantages to employing the gas circulation system 10of the subject invention as compared to a system that utilizes the gassealed access port disclosed for example in U.S. Pat. No. 8,795,223. Inparticular, with respect to the access port 26, by removing the need forboth an inner and outer cannula, because of the use of a separateconventional cannula for insufflation and sensing, there is asignificant reduction in the effective outer diameter of the tubularbody of the access port 26.

FIGS. 9 and 10 illustrate this comparison, wherein FIG. 10 shows thetubular body portion 55 and central bore 57 of a 5 mm dual lumen gassealed access device constructed in accordance with the disclosure ofU.S. Pat. No. 8,795,223, which has an effective outer diameter D₁ ofabout 11.05 mm, whereas FIG. 9 shows a 5 mm version of the single lumengas sealed access device 26 of the subject invention, which has atubular body portion 52 with an effective outer diameter D₂ , forexample, of about 8.97 mm. It should be understood that the respectivecentral bores 54, 57 of body portions 52, 55 have the same innerdiameters.

This significant difference in the effective outer diameter of thesingle lumen gas sealed access port 26 of the subject invention enablessurgery with a smaller patient incision, while maintaining similarfunctionality (i.e., gaseous sealing for instrumentation, stablepneumoperitoneum and smoke evacuation). A smaller incision size can alsolead to smaller or invisible scars for the patient, less pain or painmedication, easier wound closure for the surgeon, etc. In addition, thesingle lumen gas sealed access port 26 of the subject invention usesless plastic and has fewer components than the gaseous sealed accessport disclosed for example in U.S. Pat. No. 8,795,223, and the singlelumen design eliminates several mating features. This could allow forlower component and assembly costs, as well as more efficient productqualification.

Those skilled in the art will readily appreciate that the tubular bodyportion 52 of the access port 26 can be introduced into the abdominalcavity of a patient through the abdominal wall using an inserter orobturator. In this regard, as best seen in FIGS. 5 and 8 the end cap 76on the proximal housing 50 includes diametrically opposed flanges 78 aand 78 b which are designed to cooperate with an obturator or introducerof the type described and illustrated in commonly assigned U.S. Pat. No.9,545,264, the disclosure of which is herein incorporated by referencein its entirety. Other types of obturators or introducers could also beutilized for this purpose.

Single Lumen Gas Sealed Trocar Without Instrument Passage

Referring now to FIGS. 11 through 24, while the single lumen gas sealedaccess port 26 described above is adapted and configured to performgaseous sealing for surgical instrumentation passing therethrough,stable cavity pressure and smoke evacuation of the surgical cavity, aswell as being constructed to permit air entrainment and emergency reliefof cavity pressure, it is also envisioned and well within the scope ofthe subject disclosure that an embodiment of the subject invention doesnot necessarily have to provide instrument access to the surgicalcavity, but rather it can be configured as a single lumen gas sealedtrocar without an instrument passage.

For example, there is illustrated in FIGS. 11 and 12, a gas sealedtrocar 126 that is adapted and configured to maintain stable cavitypressure and effect smoke evacuation of a surgical cavity, as well aspermit air entrainment and emergency pressure relief, by way of aconcentric dual lumen manifold 160, but without permitting instrumentaccess into and through the central cannula bore 154 of the body portion152. In this regard, the central bore 154 of the gas sealed trocar 126is covered by a louvered end cap 176 on housing portion 150 thatincludes a set of spaced apart slots 180, which physically prevent orotherwise block instrument access into and through the central bore 154of the trocar 126.

Because surgical instruments are not inserted into this gas sealedtrocar 126, the inside diameter (and therefore the outside diameter ofthe device) can be reduced significantly without sacrificing gaseoussealing functionality, as shown for example in FIGS. 16-17, described inmore detail below. This can further increase the potential size-basedadvantages of the port of the subject invention. A gas sealed trocar ofthis type can have many alternative embodiments. For example, shown inFIGS. 18-20 and later described, the trocar device could include athinner and/or flatter channel or an oblong channel, since the conduitdoes not have to be cylindrical in order to provide a gaseous sealaround cylindrical surgical instruments. This design may allow forclinical advantages as the elliptical or oblong geometry of thisembodiment aligns more closely with the linear skin incision made by thesurgeon and therefore may provide for easier insertion and less traumato the tissue surrounding the incision.

The trocar device also does not have to include a straight orlongitudinal pathway. For example, as shown in FIG. 13, a gas sealedtrocar 226 with a proximal housing portion 250 having a louvered end cap176 and bi-lumen manifold 260 could include a non-linear body portion252 that is configured to bend 90 degrees from its axis. Thisconstruction allows for a number of improvements such as anchoring to apatient's abdominal wall during a laparoscopic surgical procedure,providing enhanced or user-directed smoke evacuation range and coverage,and eliminating clutter within the working space both inside and outsideof the abdominal cavity.

Referring now to FIGS. 14-15, there is illustrated a gas sealed trocar326 for performing an endoscopic surgical procedure in a surgical cavityof a patient, which includes a proximal housing portion 350 and anelongated single lumen tubular body portion 352 extending distally fromthe proximal housing portion 350 and defining a central cannula 354. Theproximal housing portion 350 has an inlet path 356 for communicatingwith a pressurized gas line 30 of a tube set 20 and an outlet path 358for communicating with a return gas line 32 of the tube set 20. Theproximal housing portion 350 includes a manifold 360 defining the inletpath and the outlet path, wherein the inlet and outlet paths arearranged in parallel within the manifold 360. Alternatively, paths 356and 358 could be formed in a manner that is integral with the proximalhousing portion 350, without requiring a separate manifold.

The proximal housing portion 350 accommodates an annular jet assembly364 for receiving pressurized gas from the inlet path 356 and forgenerating a gaseous sealing zone within the central cannula 354 of thetubular body portion 352 to maintain a stable pressure within thesurgical cavity of the patient, wherein the proximal housing portion 350is adapted and configured to permit air entrainment, but the bodyportion 352 is closed off to prevent access through the central cannula354 into the surgical cavity, as described further below.

The proximal housing portion 350 includes a manifold 360 defining theinlet path and 356 the outlet path 358, wherein the inlet and outletpaths are arranged in parallel within the manifold 360. The proximalhousing portion 350 also includes suture securement tangs 394 tofacilitate securement of the device 326 during a surgical procedure. Theproximal housing portion 350 further includes an end cap 376 withcircumferentially disposed radial slots 377 to permit air entrainmentand emergency relief of cavity pressure. The end cap 376 is alsoconfigured with a central aperture 378 to receive a plug 390 for closingthe central cannula 354 of the tubular body portion 352, and therebyprevent air entrainment, if the need arises.

A distal end section of the tubular body portion 352 forms a closedconical tip 355 for facilitating percutaneous introduction of thedevice. Moreover, the closed distal tip 355 prevents the passage of asurgical instrument into the patient's body cavity through the centralcannula 354. The distal end section of the tubular body portion 352includes a plurality of apertures 392 for facilitating gas/fluidcommunication between the central cannula 354 of the tubular bodyportion 352 and the surgical cavity of the patient.

Referring now to FIGS. 16 and 17, there is illustrated a gas sealedtrocar 426 for performing an endoscopic surgical procedure in a surgicalcavity of a patient, which includes a proximal housing portion 450 andan elongated single lumen tubular body portion 452 extending distallyfrom the proximal housing portion 450 and defining a central cannula454.

The proximal housing portion 450 includes an end cap 476 that permitsair entrainment and a dual lumen manifold 460 defining the inlet path456 and the outlet path 458, wherein the inlet and outlet paths arearranged in a concentric manner within the manifold 460, rather than ina parallel manner as shown in FIG. 14. The proximal housing portion 450further includes suture securement tangs 494.

In this embodiment, the tubular body portion 452, and more particularlythe central bore or cannula 454 is dimensioned to prevent the passage ofa surgical instrument therethrough. For example, the bore 454 could bedimensioned to prevent the introduction of a standard 5 mm endoscopicsurgical device commonly used during laparoscopic surgery. Thus, theinner diameter “d” of bore 454 would be less than 5 mm. However, in suchan instance, the obturator or introducer 490 would be dimensioned topass through the central bore 454 to facilitate the percutaneousintroduction of the trocar 426.

Referring now to FIGS. 18-20, there is illustrated a gas sealed trocar526 for performing an endoscopic surgical procedure in a surgical cavityof a patient, which includes a proximal housing portion 550 and anelongated single lumen tubular body portion 552 extending distally fromthe proximal housing portion 550 and defining a central cannula 554. Theproximal housing portion 550 includes a manifold 560, wherein the inletand outlet paths are arranged in a parallel manner.

As best seen in FIG. 20, the tubular body portion 552 has a non-circularcross-sectional configuration. More particularly, as shown in FIG. 20,the tubular body portion 552 has an elliptical cross-sectionalconfiguration. Also, an adhesive pad 598 is operatively associated withthe tubular body portion 552 for retaining the trocar 500 in placeduring a surgical procedure.

Referring now to FIGS. 21-24, there is illustrated another embodiment ofa single lumen gas sealed trocar constructed in accordance with thesubject invention, which is designated generally by reference numeral626. Gas sealed trocar 626 includes a proximal housing portion 650 andan elongated single lumen tubular body portion 652 extending distallyfrom the proximal housing portion 650 and defining a central cannula654. The proximal housing portion 650 includes a manifold 660, whereinthe inlet and outlet paths are arranged in a parallel manner.

The proximal housing portion 650 further includes a hinged end cap 676that is mechanically actuated and mounted to move from an open positionshown in FIGS. 21-23 to a closed position shown in FIG. 24 upon theremoval of an obturator 690 from the trocar 600 to prevent access to thecentral cannula 654. More particularly, the proximal housing portion 650and the hinged end cap 676 are operatively connected to one another bybiasing bands 675 that bias the end cap 676 into a normally closedposition.

The end cap 676 has louvers or spaced apart slots 648 that permit airentrainment into the central cannula 654 and emergency relief of cavitypressure without permitting instrument access into and through thecentral cannula 654 of the tubular body portion 652. In addition, alocking mechanism 685 is provided on the proximal housing portion 650for retaining the hinged end cap 676 is the closed position, as bestseen in FIG. 24. More particularly, the locking mechanism 685 includes apair of locking tabs 685 a and 685 b for capturing and retaining theflange 677 of the end cap 676.

Separable Two-Part Single Lumen Gas Sealed Access Port for RoboticSurgery

Referring to FIGS. 25 through 30, there is illustrated anotherembodiment of the gas circulation system of the subject invention whichis designated generally by reference numeral 710, and which isconfigured for use in robotically assisted minimally invasive surgicalprocedures. More particularly, the gas circulation system 710 is adaptedfor use in conjunction with a Da Vinci Xi type robotic system that ismanufactured and sold by Intuitive Surgical, Inc.

Referring to FIG. 25, the gas circulation system 710 includes amulti-lumen tube set 20 having a dual lumen portion 22, a single lumenportion 24 and a multi-path filter cartridge assembly 36. The dual lumenportion 22 is adapted and configured to communicate with a separabletwo-part single lumen gas sealed access port designated generally byreference numeral 726. The single lumen portion 24 is adapted andconfigured to communicate with a separable two-part single lumen valvesealed access port designated generally by reference numeral 728.

Referring to FIG. 26, the gas sealed access port 726 is particularlyconfigured for use in robotic surgery. It includes a proximal housingportion 750 that is adapted to be selectively coupled with a separatetubular body portion 752, as described in more detail below. The tubularbody portion 752 is configured for manipulation by a robotic surgicalsystem. More particularly, the proximal reception portion 755 of thetubular body portion 752 includes a radially outwardly extendinggrasping flange 757 for enabling a Da Vinci Xi type robotic manipulator(not shown) to grasp and move the abdominal port 750 during a minimallyinvasive surgical procedure.

With reference to FIGS. 27-30, the proximal housing portion 750 of thegas sealed access port 726 includes a lower housing portion 751dimensioned and configured to be accommodated within the upper receptionportion 755 of the tubular body portion 752. An O-ring 759 is providedwithin the upper reception portion 755 to seal against the exterior oflower housing portion 751. A tubular stem 753 extends through and fromthe lower housing portion 751 to communicate directly with the tubularbore or cannula 754 of the tubular body portion 752, when the twostructures are attached together for use.

Referring to FIG. 30, the proximal housing portion 750 further includesan interior chamber to accommodate an annular jet assembly 764. Theannular jet assembly 764 is configured to receive pressurized gas fromthe inlet path 756 and generate a gaseous or pneumatic sealing zonewithin the tubular stem 753. Because the tubular stem 753 is inpneumatic communication with the central cannula bore 754 of the tubularbody portion 752, the device can maintain a stable cavity pressure andprovide smoke evacuation.

With reference to FIGS. 27 and 29, the proximal housing portion 750 ofaccess port 726 is configured to be selectively or otherwise detachablycoupled to the tubular body portion 752 by a pair of diametricallyopposed spring-loaded locking tabs 740 a and 740 b. As best seen in FIG.28, the separable housing portion 750 also includes a dual lumenmanifold 760 to manage the flow of the pressure and return lines throughconcentric paths 756, 758. Alternatively, as shown in FIG. 27A, themanifold 760 could include parallel inlet and outlet paths 756 and 758.

Separable Two-Part Single Lumen Gas Sealed Access Port for EndoscopicSurgery

Referring now to FIGS. 31 through 34, there is illustrated anotherembodiment of the gas circulation system of the subject invention whichis designated generally by reference numeral 810, which is adapted andconfigured for use in endoscopic surgical procedures. The system 810includes a multi-lumen tube set 20 having a dual lumen portion 22, asingle lumen portion 24 and a multi-path filter cartridge assembly 36.

Referring to FIG. 31, the dual lumen portion 22 of tube set 20 isadapted and configured to communicate with a two-part single lumen gassealed access port designated generally by reference numeral 826, whichincludes a proximal housing portion 850 and a separable tubular bodyportion 852. The single lumen portion 24 of tube set 20 is adapted andconfigured to communicate with a two-part single lumen valve sealedaccess port designated generally by reference numeral 828, whichincludes a proximal housing portion 823 and a separable tubular bodyportion 825. Those skilled in the art will readily appreciate that thesingle lumen portion 24 of tube set 20 can be connected to a one-piecevalve sealed access port, without departing from the spirit or scope ofthe subject invention.

Referring to FIGS. 32 and 33, the gas sealed access port 826 includes aproximal housing portion 850 that is adapted to be selectively coupledwith the upper reception portion 855 of tubular body portion 852. Moreparticularly, the proximal housing portion 850 of the access port 826 isconfigured to be selectively coupled to the upper reception portion 855of tubular body portion 852 by a pair of diametrically opposedspring-loaded locking tabs 840 a and 840 b operatively associated withthe upper reception portion 855.

The separable housing portion 850 includes an end cap 876 and a duallumen manifold 860 to manage the flow of the pressure and return lines.Housing portion 850 also has an interior chamber that accommodates anannular jet assembly 864 configured to generate a gaseous or pneumaticsealing zone within the central cannula bore of the separable tubularbody portion 852, to maintain a stable cavity pressure and provide smokeevacuation.

Method of Deploying a Single Lumen Two-Part Gas Sealed Access Port

Referring to FIGS. 35-38, the subject invention is also directed to anovel method of retrofitting a separable two-part valve sealed surgicalaccess port to perform an endoscopic surgical procedure in a surgicalcavity of a patient. As shown in FIG. 35, the method first includes thestep of obtaining a separable two-part surgical access port 926 having avalve sealed proximal housing portion 950 that is detachably engaged toa single lumen tubular body portion 852. The proximal housing portion950 includes a mechanical duckbill valve 995 and a conventional luertype fitting 925.

The method further incudes the steps of detaching the valve sealedproximal housing portion 950 from the single lumen tubular body portion852, as shown in FIG. 36, and then selectively attaching a gas sealedproximal housing portion 850 with manifold 860 to the single lumentubular body portion 852, as shown in FIG. 37. Then, as shown in FIG.38, the method further includes the step of connecting the gas sealedproximal housing portion 850 of the assembled port 826 to a source ofpressurized gas for generating a gaseous sealing zone within a centralcannula of the single lumen tubular body portion 852 to maintain astable pressure within the surgical cavity of a patient.

While the gas circulation system, multi-lumen tube set and gas sealedaccess ports and trocars of the subject disclosure has been shown anddescribed with reference to preferred embodiments, those skilled in theart will readily appreciate that changes and/or modifications may bemade thereto without departing from the scope of the subject disclosure.

What is claimed is:
 1. A surgical access port for performing anendoscopic surgical procedure in a surgical cavity of a patient,comprising: a proximal housing portion and an elongated single lumentubular body portion extending distally from the proximal housingportion and defining a central cannula, the proximal housing portionaccommodating an annular jet assembly for generating a gaseous sealingzone within the central cannula of the tubular body portion to maintaina stable pressure within the surgical cavity of the patient.
 2. Asurgical access port as recited in claim 1, wherein the proximal housingportion has an inlet path for communicating with a pressurized gas lineof a tube set and an outlet path for communicating with a return gasline of the tube set.
 3. A surgical access port as recited in claim 2,wherein the annular jet assembly is adapted and configured to receivepressurized gas from the inlet path to generate the gaseous sealing zonewithin the central cannula of the tubular body portion.
 4. A surgicalaccess port as recited in claim 2, wherein the proximal housing portionincludes a manifold defining the inlet path and the outlet path, andwherein the inlet and outlet paths are concentrically arranged withinthe manifold.
 5. A surgical access port as recited in claim 2, whereinthe proximal housing portion includes a manifold defining the inlet pathand the outlet path, and wherein the inlet and outlet paths are arrangedin parallel within the manifold.
 6. A surgical access port as recited inclaim 1, which is adapted and configured to perform smoke evacuationfrom the surgical cavity of the patient in conjunction with anotheraccess port.
 7. A surgical access port as recited in claim 1, which isadapted and configured to permit air entrainment into the centralcannula of the tubular body portion.
 8. A surgical access port forperforming an endoscopic surgical procedure in a surgical cavity of apatient, comprising: a proximal housing portion and an elongated singlelumen tubular body portion extending distally from the proximal housingportion and defining a central cannula, the proximal housing portionhaving a manifold defining an inlet path for communicating with apressurized gas line of a tube set and the outlet path for communicatingwith a return gas line of the tube set, wherein the inlet and outletpaths are concentrically arranged within the manifold.
 9. A surgicalaccess port as recited in claim 8, wherein an annular jet assembly isaccommodated in the proximal housing portion for receiving pressurizedgas from the inlet path and for generating a gaseous sealing zone withinthe central cannula of the tubular body portion to maintain a stablepressure within the surgical cavity of the patient.
 10. A surgicalaccess port as recited in claim 8, which is adapted and configured toperform smoke evacuation from the surgical cavity of the patient inconjunction with another access port.
 11. A surgical access port asrecited in claim 8, which is adapted and configured to permit airentrainment into the central cannula of the tubular body portion.
 12. Asurgical access port for performing an endoscopic surgical procedure ina surgical cavity of a patient, comprising: a proximal housing portionand an elongated single lumen tubular body portion extending distallyfrom the proximal housing portion and defining a central cannula, theproximal housing portion having an inlet path for communicating with apressurized gas line of a tube set and an outlet path for communicatingwith a return gas line of the tube set, the proximal housing portionaccommodating an annular jet assembly for receiving pressurized gas fromthe inlet path and for generating a gaseous sealing zone within thecentral cannula of the tubular body portion to maintain a stablepressure within the surgical cavity of the patient.
 13. A surgicalaccess port as recited in claim 12, which is adapted and configured toperform smoke evacuation from the surgical cavity of the patient inconjunction with another access port.
 14. A surgical access port asrecited in claim 12, which is adapted and configured to permit airentrainment into the central cannula of the tubular body portion.
 15. Asurgical access port as recited in claim 12, wherein the proximalhousing portion includes a manifold defining the inlet path and theoutlet path, and wherein the inlet and outlet paths are concentricallyarranged within the manifold.
 16. A surgical access port as recited inclaim 12, wherein the proximal housing portion includes a manifolddefining the inlet path and the outlet path, and wherein the inlet andoutlet paths are arranged in parallel within the manifold.